Tuesday, December 18, 2018

Shannon Withycombe's "Lost: Miscarriage in Nineteenth-Century America"

Shannon Withycombe is an assistant professor of history at the University of New Mexico in Albuquerque.

She applied the “Page 99 Test” to her new book, Lost: Miscarriage in Nineteenth-Century America, and reported the following:
Lost traces the miscarriage experiences of multiple women in nineteenth-century America, placing each one within the context of national reproductive policies, medical advances and authority, demographic and social changes, and personal desires and struggles. Throughout the book, I continually come back to the question: why did women begin to utilize the services of male doctors for help with miscarriage during the second half of the nineteenth century? There is nothing inherently “medical” about miscarriage, and American women had dealt with the experience for centuries with the help of female relatives and friends. This page gives some clues to why women did not seek out medical aid in the first half of the nineteenth century.

From page 99:
On January 2, 1852, Virginia physician P. Claiborne Gooch attended a thirty-year-old mother of three who had been “ailing and sore through the night.” Although she had continued her work the following day, even while suffering fatigue and dull pain in her lower body, she did not call on Gooch until the pains became “grinding and benumbing,” similar to labor pains. Gooch examined the woman and discovered her to be five to six months pregnant and passing a good deal of blood. Upon finding her cervix dilated, he determined the miscarriage would be unavoidable. In his report of this case in the Ohio Medical and Surgical Journal two months later, he wrote that upon this determination “I quietly took my bed-side seat till nature accomplished her duty – mine being merely to send the husband out of the room, and to inform the women that the accident must take place.” He continued to watch his patient, and later that night attempted to gently remove the mass once it had descended into her vagina, but when he found that such an action was impossible without a risk of violence, he “desisted, and waited till 10 o’clock on Nature.” Instead he gave her a solution of ergot, a fungus believed to induce and strengthen uterine contractions. Around midnight, the woman finally expelled the fetus, with little active aid from the doctor.
In the middle of the nineteenth century, American doctors began attempting to gain a foothold in the business of miscarriage. Viewing pregnancy loss not only as a space for potential profit, but also an avenue into the bigger business of childbirth, doctors tried to alter the meaning of miscarriage into more of a dangerous ailment, one that they were uniquely qualified to treat. However, when women did call upon them, like in the case above, doctors still had nothing new or exciting to offer them. Dr. Gooch had no special tool or medicine to prevent the miscarriage or speed it up, and instead sat patiently at the women’s bedside, waiting upon nature to take its course. This “expectant” treatment, as many critical physicians would refer to it later, did nothing to convince reproducing women and their families that doctors were any use in cases of miscarriage.

So what did shift popular sentiment? Why did more women by the end of the nineteenth century seek out medical men during miscarriages? Necessity. In the second half of the nineteenth century, millions of women found themselves physically and socially separated from family, traditional healers, and familiar reproductive aid. Due to immigration, urbanization, and industrialization in late nineteenth-century America, women began utilizing the services of male physicians because they had nowhere else to turn. The rest of Lost explores the new world of late nineteenth century America and how social, legal, demographic, and economic changes shifted how many women dealt with miscarriage, and even what a miscarriage could mean.
Learn more about Lost: Miscarriage in Nineteenth-Century America at the Rutgers University Press website.

--Marshal Zeringue